Reproductive System & Immune system drugs Flashcards
Andropause
male climacteric: decrease level in testosterone
male menopause
The Human Sexual Response
-Estrous cycle: endocrine stimuli for sexual response to occur.
- Four phases:
1. stimulation- mild increases in sensitivity and beginning stimulation of SNS
2. plateau- stimulation levels off
3. climax- massive SNS stimulation
4. resolution- recovery
**Drugs for the Female Repro. System**
- sex hormones
- estrogen receptor modulators
- fertility drugs
- uterine motility drugs
need to know these
Sex Hormones
estrogens
progesterones
amenorrhea
absence of menses
Other Tocolytics: nifedipine
Ca channel blocker- drops BP
- supreses contractions
- look out for orthostatic hypotension
other tocolytics: Magnesium
- watch for magnesium toxicity: decreased DTR, U/O <30 ml/hr, respiratory depression
- calcium gluconate antidote for Mg toxicity (give IV)
- endomethacine- blocks prostaglandin synthesis which suppresses labor.
Drug classifications affecting the male reproductive system (3)
- androgens
- anabolic steroids
- drugs for penile erectile dysfunction
testosterone
produced in testes, responsible for male characteristics before puberty.
androgens
produced in adrenal glands, sustains male characteristics after puberty
verilization
development of male characteristics
Autoimmune diseases
- celiac disease: triggered by gluten
- chron’s: GI inflammation
- Grave’s: too much thyroid
- Gullian Barre syndrome: neuromusc. disorder that attacks nerves
- Lupus: skin, joints, kidneys
- MS:
lupus
where the body attacks its own skin and joints
Immunosuppresant: Epinephrine
- vasopressor (stimulates alpha and beta)
- increase BP and HR
- bronchodilation
- cardiac arrest
- anaphylaxis reaction
Epi-pen Indications
- severe anaphylactic reaction: deadly hypotension and bronchoconstriction
- first drug use for anaphylactic reaction
- auto-injector
First signs of anaphylactic reaction
- Hives
- Dyspnea
- Hypotension
ABC’s
Epi-Pen dose
- One shot to the thigh
- Repeat q 5-15 mins until symptoms resolve
- Steps: stab thigh, hold it there for 10 sec., Benadryl, Albuterol, Steroids
Marijuana
- high THC
- derived from cannabis indica or cannabis sativa families
- amount of THC increased over the past 20 years (5-35%)
Hemp (CBD)
- low THC, high CBD
- CBD is also echinachea, chocolate, truffles also have CBD
- derived only from cannabis sativa (hemp) family
- around 0.3% THC
Inhaled marijuana
- onset of psychoactive effects occurs rapidly with peak effects felt at 15-30 minutes
- lasting up to 4 hours
- pulmonary bioavailability varies from 10 to 35 percent of an inhaled dose
- determined by depth of inhalation along with the duration of puffing and breath holding
ingested marijuana
- delayed onset of psychoactive effect that ranges from 30 min - 3 hours
- clinical effects may last up to 12 hours
- orally administered has low bioavailability (5 - 20 %) because of chemical degradation in gastric acid and substancial first-pass metabolism in liver
- in native users, psychotropic effects occur with 5 - 20 mg of ingested THC
Legal THC drugs in U.S.
dronabinol/ Marinol- n&v, MS, appetite stimulant
nabilone/ Cesamet- n&v with chemotherapy
Cannabis Intoxication s&s
- increased HR, BP, or orth. hypotension
- increased RR
- red eye, dry mouth
- nystagmus
- ataxia
- slurred speech
Complications with inhalation
- acute exacerbations and poor symptom control in patients with asthma
- pneumomediastinum ( air present in space) and pneumothorax suggested by tachypnea, chest pain, and subcutaneous emphysemas caused by deep inhalation w/ breath holding
- rarely, angina and MI
Acute cannabis intoxication
- neuro. abnormalies more in children; ataxia, excessive and purposeless motor activity of extremities, lethargy, prolonged coma (life-threatening)
- hyperemesis (bad), behavioral problems (dysphoria or agitation), bronchospasm, pneumothorax
these are medical emergencies, give IV zofran
Cannabis Hyperemeis Syndrome
- relieved by hot showers
- acute Tx: IV hydration, antiemetics and benzos.
CBD
- chronic nerve pain
- inflammation
- muscle spasms/ MS symptoms
- reduces cancer induced n&v (CINV)
- may slow cancer growth
- anxiety and terrorism
- insomnia
- acne psoriasis
- withdrawal symptoms
- seizures
First CBD approved med. by the U.S.
cannabidiol (Epidiolex)
-used to treat seizures associated with two rare and severe forms of epilepsy, Lennox-Gastaut syndrome and Dravet syndrome
Epidiolox Pharmacokinetics
- Peak concentration: 1-4 hours
- half life 12 - 32 hours
- highly lipophilic
- highly protein bound
- liver enzyme metabolism
- not expected to contribute to drug-drug interacitons
- excretion = stool and urine
Drug “roots”
willow bark = aspirin
foxglove = digoxin
aloe = burns
vinca = leukemia
mandrake root = healing
Supplements that drop BS
Ginseng ***
juniper berries
garlic
fenugreek
coriander
dandelion root
St. John’s Wort
interacts with SSRI’s
Interacts with digoxin
may make contraceptives ineffective
interacts with theophylline, cancer drugs and antivirals
Drugs Causing Bleeding
Fish oil (good for cholesterol but..)
Gingko biloba
Garlic
Ginseng
Vaccines
artificially stimulating active immunity
Types of Immunity
Active immunity: vaccines
Passive immunity: antibodies are injected into the system and react with a specific antigen
Eradicated diseases
- Smallpox
- Polio
- Measles
- Mumps
- Rubella
- Tetanus
Inactivated Vaccines
need a booster since they’re not as strong as live vaccines
- Hep A
- Flu
- Polio
- Rabies
Live-attenuated Vaccines
- MMR
- Rotavirus
- Smallpox
- Varicella
- Yellow fever
Childhood Vaccines
Following given within 1st year;
- Diphtheria, pertussis, tetanus
- Rotavirus
- Poliovirus
- Meningitis
- Haemophilus B
- Hep. B, Hep A
- MMR (after 1st year)
- Varicella (after 1st year)
